Table 2. Associations Between Left Ventricular Parameters and Death, AVS, or Combined End Points.
| Determinants | Linear LVEF (per 10%) | LVESDi (per 5 mm/m2) | LVESVi (per 5 mL/m2) | Vol-LVEF (per 10%) | LVEDVi (per 5 mL/m2) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value | |
| All-cause death under medical surveillance (n = 65)a | 0.65 (0.50-0.83) | <.001 | 1.42 (1.01-1.99) | .046 | 1.12 (1.04-1.20) | .002 | 0.61 (0.47-0.80) | <.001 | 1.05 (1.00-1.10) | .06 |
| All-cause death during total follow-up (n = 82)a | 0.65 (0.52-0.81) | <.001 | 1.38 (1.01-1.89) | .05 | 1.09 (1.02-1.17) | .01 | 0.60 (0.47-0.78) | <.001 | 1.02 (0.98-1.07) | .33 |
| Death and AVS (n = 186)a | 0.72 (0.61-0.84) | <.001 | 1.40 (1.16-1.71) | <.001 | 1.10 (1.05-1.15) | <.001 | 0.67 (0.56-0.81) | <.001 | 1.05 (1.02-1.08) | <.001 |
| AVS (n = 121)a | 0.74 (0.59-0.93) | .009 | 1.49 (1.17-1.89) | .001 | 1.10 (1.05-1.17) | <.001 | 0.70 (0.55-0.90) | .004 | 1.05 (1.02-1.09) | .002 |
| Models using previously reported cutoffs for LVESDi and LVESVi (n = 66 deaths under medical surveillance)b | HR (95% CI) | P value | ||||||||
| Model 1: LVESVi >45 mL/m2 vs ≤45 mL/m2 | 1.93 (1.10-3.38) | .02 | ||||||||
| Model 2: LVESDi >20 mm/m2 vs ≤20 mm/m2 | 1.28 (0.78-2.10) | .32 | ||||||||
| Model 3: LVESVi ≤45 mL/m2 and LVESDi ≤20 mm/m2 | 1 [Reference] | NA | ||||||||
| LVESVi >45 mL/m2 and LVESDi >20 mm/m2 | 2.00 (1.04-3.82) | .04 | ||||||||
Abbreviations: AVS, aortic valve surgery; HR, hazard ratio; LVEDVi, left ventricular end-diastolic volume index; LVEF, left ventricular ejection fraction; LVESDi, left ventricular end-systolic dimension index; LVESVi, left ventricular end-systolic volume index; NA, not applicable; Vol-LVEF, volume-derived left ventricular ejection fraction.
All analyses restricted to 490 patients (65 deaths under medical surveillance and 82 deaths during entire follow-up) who had all 5 left ventricular parameters. The adjusted (age, sex, Charlson Comorbidity Index, aortic regurgitation severity) HR, 95% CI, and P value for LVESD per 5-mm increase was 1.24 (1.00-1.54) for all-cause death (P = .05), 1.21 (0.99-1.47) for death during total follow-up (P = .06), 1.33 (1.18-1.52) for death plus AVS (P < .001), and 1.48 (1.26-1.74) for AVS (P < .001), respectively.
All models were adjusted for age, sex, Charlson Comorbidity Index, aortic regurgitation severity; for the end point of death during total follow-up, additional adjustment for time-dependent AVS was done.